Decentralized Care Across Multiple Settings: Perception vs. Research

Decentralized care team stations have been a key feature in healthcare design for decades, originating in intensive care units and expanding into a variety of care environments. Despite its widespread use, research on the impact of decentralized care stations remains inconclusive. 

Ballinger Senior Principal Louis A. Meilink, Jr., FAIA, FACHA, ACHE and Director of Healthcare Planning Fernanda Pires, EDAC, Lean Green Belt explored the topic of decentralized care stations at this year’s Healthcare Design Conference in Kansas City, MO. The presentation was developed in collaboration with University of Kansas PhD candidate Marzia Chowdhury, and sought to bridge the gap between research and practice through built examples.  

The session paired a systematic literature review, covering studies from 2007 to 2024, with Ballinger’s significant project experience to test common perceptions against evidence. Using PRISMA methods, the team reviewed 58 peer-reviewed articles and synthesized the 30 most relevant. 

Across the literature, decentralized stations are consistently linked to more patient-centered care: stronger caregiver-to-patient communication, improved patient satisfaction, and reduced medication errors. However, the research also shows tradeoffs: social interaction and staff cohesion can weaken when caregivers are spread out, and findings on efficiency and walking distance are mixed, often driven less by the stations themselves and more by broader unit planning, staffing ratios, and the location of support spaces. In other words, successful decentralization depends on the full care delivery model and unit design, not a single workstation decision.